Intermittent iron and folic acid supplementation in menstruating women
It is estimated that more than 30% of women of reproductive age worldwide are anaemic. At least half of this anaemia burden is assumed to be due to iron deficiency. Because women of reproductive age lose iron through menstruation and their diets are often lacking in available iron, they are particularly vulnerable to iron deficiency.
Daily supplementation with iron and folic acid for a period of 3 months has been the standard approach for the prevention and treatment of iron deficiency anaemia among women of reproductive age. Despite its proven efficacy, there has been limited success with the daily regimen public health programmes, which is thought to be primarily due to low coverage rates, insufficient tablet distribution and low adherence.
Recent evidence suggests that iron and folic acid supplements consumed once, twice or three times a week on non-consecutive days by all women of reproductive age are an effective, safe and more acceptable alternative to daily iron supplements.
In populations where the prevalence of anaemia among nonpregnant women of reproductive age is 20% or higher, intermittent iron and folic acid supplementation is recommended as a public health intervention in menstruating women, to improve their haemoglobin concentrations and iron status and reduce the risk of anaemia.
Additional information for this recommendation, including a suggested scheme for supplementation, can be found in the guidance summary and in the guideline, under 'WHO documents' below.
This is one of several WHO recommendations on iron and folic acid supplementation. The full set of recommendations can be found in 'Full set of recommendations'.
Systematic reviews used to develop the guidelines
- Intermittent iron supplementation for reducing anaemia and its associated impairments in menstruating women
Related systematic reviews
Effects of iron supplementation in nonanemic pregnant women, infants, and young children on the mental performance and psychomotor development of children: a systematic review of randomized controlled trials.